Of those, Governor Lynch may be the most interesting. The others represent states that either voted Republican in the last presidential election, or, in the case of North Carolina, Democratic by a hair. But New Hampshire went for Obama by more than nine percentage points. According to the Los Angeles Times, Lynch opted out because the letter failed to “address concerns regarding potential cost shifting to the states,” quoting Lynch’s press secretary.

Numerous governors, both Republican and Democrat, have raised concerns about the proposed expansion of Medicaid, which is partially funded by the states. California Gov. Arnold Schwarzenegger, one of the five Republicans who have voiced qualified support for health reform, has also raised the issue of unfunded mandates.

As for Stewart, he notes that the Republicans the White House is touting are not endorsing any of the bills currently in play on Capitol Hill. Some, like former Senate GOP leader Bill Frist, have said nice things about the Senate Finance Committee’s version; Mr. First even said he would vote for it. But he wishes he could change it. For example, he doesn’t think it does enough to bring down healthcare costs.

Stewart notes that Republicans, too, have had plenty to say about the need for change. But “there’s a difference between supporting healthcare reform (Senator McConnell, for example, has given 43 speeches on the Senate floor about the need for healthcare reform) and supporting a bill that cuts a half-trillion dollars from Medicare, raises taxes on job creators, and increases healthcare premiums,” Stewart writes in an e-mail.